I heard it during a recent IFM podcast, when the GP said that "traditional western medicine is based on a 'silo'd approach' to treating disease and dysfunction." I hadn't a clue what it meant so went and looked it up, and then it made a whole lot of sense to me.

What it means is that apart from other organisations, certainly under our conventional medicine system, if you’re having gut issues, you’ll likely see a gastroenterologist. If you’re having issues with your joints, you might see an orthopaedic specialist or a rheumatologist. And if you’re having trouble with your ability to focus or concentrate, your GP might send you to a neurologist. (If you can even get an appointment these days ... whoops - shouldn't have said that should I ...).

What this all basically means is that in essence, every specialist has been taught to stay in their own lane.

While this may seem like a good idea on paper, an unintended consequence of these silo'd specialialties is that the conventional medical community usually focuses on dealing with presenting symptoms rather than addressing the root causes of disease, which may involve other parts of the body. How come? Because, while the body comprises many systems and organs, they're all interconnected in a thousand different ways. And if you're not looking at these interconnections, you’re going to be missing a lot of information, as well as missing the opportunity of connecting the dots. 

Instead of seeing specialist after specialist in an unconnected series of doctor’s visits, the IFM asks the question, “What if all of these symptoms are related or linked together by a common cause?”

A perfect example of this is the relationship between stress, the gut, and the brain.

How stress derails the gut-brain connection

If you look at the leading causes of death in us humans, it's unlikely that you'll find chronic stress listed among them. However, the reality is that long-term stress can, and does, drive all sorts of disease and dysfunction, much of it directed at the gut-brain connection.

Stress disrupts the communication between the brain and the gut (microbiome), leading to increased pain, bloating, and discomfort. However, the gut’s bacteria also influence the brain’s health and emotions, hence why these days the gut biome is often referred to as the body’s 'second brain' because of the amount of communication going on between it and the actual brain.

Additionally, chronic stress affects eating habits, switches off digestion, and radically affects bowel function. It weakens the intestinal barrier, allowing bacteria to enter the bloodstream (leaky gut) and causes truly chronic symptoms. For our horses, chronic hindgut disorders are particularly affected by stress due to heightened sensitivity, changes in the gut biota, digestion and peristaltis speed, and weakening immune responses.

Long and short, it doesn’t take a medical degree to understand that the cumulative effects of chronic stress aren't good for the gut or the brain, leading to an unwelcome cycle of disease and dysfunction.

A (human) case study featuring SIBO (Small Intestinal Bacterial Overgrowth)

This real-life example really emphasises the effect of stress on the gut-brain connection involving small intestinal bacterial overgrowth (SIBO). SIBO is a phenomenon where unfriendly gut microbes grow in the small intestine, turning it into an acidic environment when normally it should always be sterile. This can lead to issues like bloating and a distended stomach - it’s said that people with SIBO may feel like they have a 'food baby' after they eat or that it doesn’t feel like they've 'fully evacuated' (to put it politely) when they have a bowel movement.

A quick digress back to our horses, and we all know these days that it's the hindgut region/colon which is the deciding point as to whether we have a healthy horse or not. Those friendly hindgut fibre-fermenting microbes, as in the biome that reside in the colon, normally live perfectly happily, fermenting all the lovely fibre from the grass forage that our horse has eaten. However, if that delicate balance between friendly v. unfriendly microbes becomes disrupted, triggering a rapid overpopulation and colonisation of the unfriendly acid-forming microorganisms, this forces a drop in the pH level, creating an acidic environment known as hindgut acidosis. Cue the domino-effect of dysbiosis in the large intestine/hindgut, which if left unattended can lead to SIBO - small intestinal bacterial overgrowth.

Hang on - small intestine, I hear you ask? 'Fraid so. What happens is that some of those unfriendly acidic bugs from the hindgut find their way back up into the small intestine, which isn't good at all because as said earlier, the small intestine is meant to be mostly sterile (minus a small amount of beneficial bacteria) and needs to remain that way at a neutral, non-acidic, pH. If the bad bacteria move in and take over, they'll start 'fermenting' the digesta in the small intestine, i.e. the sugars, starches and proteins, which isn't how these nutrients should be digested - they're broken down by digestive enzymes, so if this starts to happen we're in trouble. In humans this is what causes IBS.

However, SIBO can lead to a number of other seemingly non-gut-related problems as well. People dealing with this issue can experience fatigue, anxiety, and even depression. And while there can be a number of causes of SIBO, stress also plays a major role. This means, ironically, that stress can cause SIBO, which in turn can cause the body to become even more stressed!

The podcast illustrated how bad the effects of SIBO can be, with one of the well-know IFM GPs citing a recent case where he saw a patient suffering from vestibular migraines, which is essentially the migraine from hell. By the time she got to him, she’d seen close to 45 doctors and was rattling from being on all kinds of pharma meds, but nothing was working.

He investigated her situation further and discovered that she was also feeling bloated all the time and her belly was distended - classic signs of SIBO. She had also gained a chunk of unwelcome weight, she was deeply depressed, and she was experiencing terrifying anxiety attacks that at times were driving her to feeling suicidal.

Instead of focusing on just the symptoms – the migraines, depression and anxiety, he looked to what he thought was the root of the problem - SIBO. And cut a long one short, he helped her clean up her gut, removed all the gut-damaging inflammatory foods from her diet, and gave her gut a detox which included antifungals to kill off the bad bugs.

Six weeks later, she looked - and felt - like a different person. Not only had all the inflammation gone out of her body, but she had also lost 10-kilos. Her gut was back to normal and apparently to date she hasn’t had a migraine since. A classic example of the gut:brain:stress connection, when malfunctioning due to stress can lead to symptoms that reinforce themselves which may not seem related to the gut at all.

Pulling this all together, and whether human or horse, there are lots of positive changes we can make:

• Prioritize exercise and rest - this is the foundation of a healthy life. You simply can’t deal with stress well when you’re treating the body like junk. Consistent exercise, even gentle, and quality rest can drastically lower stress levels over time.
  
  
• Remove gut-busters from the diet. A rubbish C.R.A.P. diet (carbs, refined, artificial, processed) is a major contributing factor to issues like SIBO, so get them gone. For our horses, we know they’re evolved to eat only grass forage, so if a feedbowl isn’t made from grass, don’t feed it - simples 😉. Oh, and avoid haylage. For us humans, try eliminating  known inflammatory foods like gluten, dairy, soy, and anything that contains sugar, caffeine, or alcohol.

• In addition, consider reducing or eliminating non-steroidal anti-inflammatory drugs (NSAIDs), unnecessary antibiotics and steroids, as well as the dreaded acid blockers.

• Environmental toxins, many of which we can’t do much about. We’re bombarded with toxic materials from every front, and once in the body – and be assured they’re going to come in – they're stored in tissues and cells, right down at molecular level throughout the body, and they'll affect every one of the body’s systems, including the ones that life depends on - immune, digestive, nervous and circulatory. Either way, a regular detox will go a long way to help.

• Add in biome-builders. The best way to promote a healthy gut is with gut-supporting foods that the friendly gut bugs love.

• For our horses it’s about supporting a healthy intestinal tract environment for the beneficial microbiome biota with what's commonly known as the 'oily herbs' - see our BiomeTonic. Also, add valuable and natural prebiotic roughage diversity into their diet, i.e. roots, barks, berries, moss, leaves, nuts, flowers etc., to get variety and essential nutrients into their diets to support their metabolism - see our WildFed.

• For humans there’s so much more we can do:
• aim for at least 25g of fibre/day,
• eat an abundance of polyphenol-rich veggies – look to fill your plate ¾-full with non-starchy veg,
• include plenty of prebiotic foods such as Jerusalem artichoke, garlic, onions, leeks, dandelion greens, asparagus,
• include plenty of probiotic foods like sauerkraut, kimchi, pickles, fermented soy, unsweetened yogurt or kefir, and miso.

These days we’re learning more and more about how the gut and brain communicate, and how stress can impact this relationship. While I know we’re covering just the tip of the iceberg here, the takeaway message is that it’s really easy to take some basic steps towards healthier living for both us and our beloved Ned's 😉.